The Future of LSD Psychotherapy

Stanislav Grof, M.D.

In the preceding sections of this book I have tried to express
and illustrate my belief that LSD is a unique and powerful tool
for the exploration of the human mind and human nature. Psychedelic
experiences mediate access to deep realms of the psyche that have
not yet been discovered and acknowledged by mainstream psychology
and psychiatry. They also reveal new possibilities and mechanisms
of therapeutic change and personality transformation. The fact
that the spectrum of the LSD experience appears puzzling to most
professionals and cannot be accounted for by the existing theoretical
frameworks does not mean that the effects of LSD are totally unpredictable.
The safe and effective use of this drug requires a fundamental
revision of the existing theory and practice of psychotherapy.
However, it is possible to formulate basic principles for LSD-assisted
psychotherapy which maximize its therapeutic benefits and minimize
the risks.
It is very difficult at this point to predict the future of LSD
psychotherapy. The fact that it can be used safely and effectively
does not automatically mean that it will be assimilated by mainstream
psychiatry. This issue is complicated by many factors of an emotional,
administrative, political and legal nature. However, we should
clearly differentiate between the future of LSD psychotherapy
and its contribution to the theory and practice of psychiatry.
I mentioned earlier in this volume that LSD is a catalyst or amplifier
of mental processes. If properly used it could become something
like the microscope or the telescope of psychiatry. Whether LSD
research continues in the future or not, the insights that have
been achieved in LSD experimentation are of lasting value and
relevance.
The theoretical formulations and practical principles that LSD
psychotherapy has discovered or validated include a new, expanded
cartography of the human mind, new and effective therapeutic mechanisms,
a new strategy of psychotherapy, and a synthesis of spirituality
and science in the context of the transpersonal approach. In addition,
the recent rapid convergence between mysticism, modern consciousness
research and quantum-relativistic physics suggests that psychedelic
research could contribute in the future to our understanding of
the nature of reality.
It is true that psychedelic experimentation has its dangers and
pitfalls. But ventures into unexplored areas are never without
risk. Wilhelm Conrad Roentgen, the discoverer of x-rays, lost
his fingers as a result of his experiments with the new form of
radiation. The mortality-rate of the early pilots who paved the
way for today's safe jet travel was allegedly 75 percent. The
degree of risk is directly proportional to the significance of
the discovery, and its potential; thus the invention of gun powder
involved a different level of risk from the development of nuclear
energy. LSD is a tool of extraordinary power; after more than
twenty years of clinical research I feel great awe in regard to
both its positive and negative potential. Whatever the future
of LSD psychotherapy, it is important to realize that by banning
psychedelic research we have not only given up the study of an
interesting drug or group of substances, but also abandoned one
of the most promising approaches to the understanding of the human
mind and consciousness.
The present prospects for systematic LSD research and its extensive
use in psychotherapy look rather grim. It is difficult at this
point to say whether or not the situation will change, though
there are indications that the general climate might become more
favorable in the years to come.
One of the major problems in LSD psychotherapy was the unusual
nature and content of the psychedelic experience. The intensity
of the emotional and physical expression characteristic of LSD
sessions was in sharp contrast to the conventional image of psychotherapy,
with its face-to-face discussions or disciplined free-associating
on the couch. The themes of birth, death, insanity, ESP, cosmic
unity, archetypal entities, or past-incarnation memories occurring
in psychedelic states were far beyond the conventional topics
of psychotherapy which emphasized biographical data. An average
professional at that time felt reluctance toward or even fear
of the experiential realms of this kind because of their association
with psychosis. At present, intense emotional outbursts, dramatic
physical manifestations, and various perinatal and transpersonal
experiences are much more acceptable to and less frightening for
many therapists because they can be encountered quite routinely
in the context of the new experiential therapies, such as Gestalt
practice, encounter groups, marathon and nude marathon sessions,
primal therapy, and various neo-Reichian approaches. Many modern
therapists value and encourage various dramatic experiences which
in the framework of classical analysis would be seen as dangerous
acting-out and considered a reason for discontinuation of treatment
or even psychiatric hospitalization. Some modern approaches to
schizophrenia actually encourage deep experiential immersion into
the process instead of its chemical inhibition. For new therapists
of the above orientation, psychedelics would naturally be the
next step to help accelerate and deepen the process.
LSD entered the scene at the time of the psychopharmacological
revolution, when new tranquilizers and antidepressants had their
early triumphs and generated excessive hope for easy chemical
solutions to most of the problems in psychiatry. At present much
of the original enthusiasm in this area has tapered off. While
appreciating the humanization of the mental hospitals and pacification
of psychiatric wards which has brought their atmosphere close
to that of general hospitals, it is becoming increasingly obvious
that tranquilizers and antidepressants are, by and large, only
symptomatic remedies. They do not solve the problems and in more
serious cases lead to a life-long dependence on maintenance medication.
In addition, there is an increasing number of professional papers
that emphasize the dangers of massive use of these drugsirreversible
neurological symptoms of tardive dyskinesia, degenerative changes
in the retina, or actual physiological addiction with a withdrawal
syndrome.
We should also mention important social forces that might play
a role in the future changes of policy toward psychedelic research.
Many of the young persons who are in or will be moving into various
positions of social relevanceas lawyers, teachers, administrators,
or mental health professionalshad intense exposure to psychedelics
during their student years. Those individuals who had experiences
themselves, or had the opportunity to observe the process in close
friends and relatives, will have formed an independent image and
will not be dependent on second-hand sources for information.
Elements of sanity in the new marijuana laws in many states may
be the first fruits of this development. The fact that ritualized
and responsible use of psychedelics received social sanction in
some ancient societies and pre-industrial countries and was meaningfully
woven into the social fabric represents a somewhat hopeful precedent.